Medical Management Specialist (Personal Injury Protection)

Erie Insurance Group
Pittsburgh
Workplace: OnsiteFull timeUSD 50,327 - 80,392 annuallyFunction: Healthcare (Clinical, Medical, Wellness)Experience: 2+ yearsEducation: bachelorsSkills: ["Decision quality","Customer focus","Collaboration","Accountability","Optimize work processes"]

Handle first-party medical benefit claims for Personal Injury Protection (PIP) with limited supervision. Evaluate coverage, investigate and resolve claim questions under applicable state laws, determine claim value and reserves, and manage case progress to conclusion. Prepare correspondence and reports, review medical and wage-loss records, process claim-related bills, and coordinate with the Home Office on serious or suspected fraud cases. Provide support for litigation strategy when needed.

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Erie Insurance Group
Erie Insurance Group
14 hours ago

Medical Management Specialist (Personal Injury Protection)

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Source: Company careers pageValidated by: Fursa AI
Last checked: 14 hours agoStatus: Live

Job Summary

Handle first-party medical benefit claims for Personal Injury Protection (PIP) with limited supervision. Evaluate coverage, investigate and resolve claim questions under applicable state laws, determine claim value and reserves, and manage case progress to conclusion. Prepare correspondence and reports, review medical and wage-loss records, process claim-related bills, and coordinate with the Home Office on serious or suspected fraud cases. Provide support for litigation strategy when needed.
Location: Pittsburgh
Workplace: Onsite
Employment Type: Full time
Job Function: Healthcare (Clinical, Medical, Wellness)
Seniority: Entry level

Key Responsibilities

  • •Handle medical management claims with limited supervision, including fatalities and wage loss claims.
  • •Evaluate and decide coverage, conduct investigations, determine total value of claims, set and maintain reserves, and manage cases to conclusion.
  • •Prepare correspondence and reports, obtain medical and employment records, and calculate wage loss claims per applicable state laws.
  • •Investigate, evaluate, and resolve coverage questions and determine whether bills/reports lead to claims being paid, compromised, or contested.
  • •Establish contact with policyholders/claimants, coordinate with the Home Office on serious/mass injury and suspected fraud cases, and assist in litigation strategy when appropriate.

Pay and Benefits

Salary: USD 50,327 - 80,392 annually
Perks:Health InsuranceDentalVisionPension401kPaid LeaveLife InsuranceDisability InsuranceAdoption Assistance

Key Requirements

  • •High school diploma or GED and two years of general claims handling experience, or a bachelor’s degree, or completion of a formal ERIE training program.
  • •Strong working knowledge of applicable state laws (preferred).
  • •Good working knowledge of human anatomy and medical terminology (preferred).
  • •Expertise in state no-fault laws and working knowledge of civil law (preferred).
  • •Designations/licensing: AIC courses preferred; appropriate license as required by state.
Experience:2+ yearsInsuranceClaimsPersonal injury protectionPIPNo-fault
Education:Bachelor's
Skills:Decision qualityCustomer focusCollaborationAccountabilityOptimize work processes
Certifications:AIC

Company Brief

Erie Insurance Group
Erie Insurance Group is a mutual insurance company providing auto, home, business, and life insurance products through a network of independent agents, serving customers across multiple U.S. states with a focus on local service and claims support.
Industry: Insurance
Company Size: Enterprise (1,001+ employees)
Growth: Established Company
Headquarters: Erie, United States
Founded: 1925
WebsiteLinkedIn